A growing literature supports the inclusion of cognitive therapy components in the treatment of posttraumatic stress disorder (PTSD) and, in many cases, concomitant depression. However, further research is needed to examine whether cognitive therapies may serve as an effective approach to emotional regulation in cases of chronic treatment-resistant PTSD (e.g., combat veterans who have been in treatment for 20 or more years). This article outlines a brief outpatient cognitive emotion-management group with a present focus. The intervention, based on cognitive appraisal theory, is designed to reduce negative cognitive appraisals and depressive symptoms among individuals with treatment-resistant PTSD. Participants were 21 men and women (4 male cohorts and 1 female cohort) in a VA treatment program for trauma-related distress who met screening criteria for high depressive symptoms and evidenced maladaptive cognitive appraisals of stress. For 14 participants with complete data, the treatment yielded partial improvement in cognitive appraisals and improvement in depressive symptoms. Although conclusions are tempered by the absence of a control group and the small sample, these findings provide preliminary support for the treatment protocol.